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Treatment Intensity of Psoriasis Decreases With Age

Treatment Intensity of Psoriasis Decreases With Age Background:Elderly patients have worse skin related quality of life regardless of psoriasis severity. Despite this, there may be risks to starting systemic immunosuppressant therapy, a mainstay for moderate to severe psoriasis, in elderly patients.Objective:We assessed how age relates to treatment intensity for psoriasis. We defined treatment intensity as a continuous scale with a value of 0 indicating no treatment, 1 indicating topical treatment only, and 2 through 4 indicating progressive degrees of systemic treatment.Methods:We assessed the National Ambulatory Medical Care Survey from 1997 to 2016 to determine if treatment intensity for psoriasis was related to a patient’s age.Results:Between 1997 to 2006, a 1-year increase in age was not associated with a change in treatment intensity score for the younger (p = .4) and older (p = .8) age groups. Between 2007 to 2016, a 1-year increase in age was associated with a .01 (95% confidence interval .005, .02) decrease in the treatment intensity score (p = .003) for patients aged 52 or older. When controlling for sex and race, a 1-year increase in age was associated with a decrease of .01 (.02, .005) in the treatment intensity score (p = .005). There was no association with those who were younger than 52 (p = .5).Discussion:Physicians provide less intense treatments for elderly patients with psoriasis. This effect has appeared in the last decade. It remains unknown if physicians are being cautious with more intense treatments in elderly patients or if they are unintentionally undertreating this population. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Psoriasis and Psoriatic Arthritis SAGE

Treatment Intensity of Psoriasis Decreases With Age

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References (6)

Publisher
SAGE
Copyright
© The Author(s) 2021
ISSN
2475-5303
eISSN
2475-5311
DOI
10.1177/2475530321995515
Publisher site
See Article on Publisher Site

Abstract

Background:Elderly patients have worse skin related quality of life regardless of psoriasis severity. Despite this, there may be risks to starting systemic immunosuppressant therapy, a mainstay for moderate to severe psoriasis, in elderly patients.Objective:We assessed how age relates to treatment intensity for psoriasis. We defined treatment intensity as a continuous scale with a value of 0 indicating no treatment, 1 indicating topical treatment only, and 2 through 4 indicating progressive degrees of systemic treatment.Methods:We assessed the National Ambulatory Medical Care Survey from 1997 to 2016 to determine if treatment intensity for psoriasis was related to a patient’s age.Results:Between 1997 to 2006, a 1-year increase in age was not associated with a change in treatment intensity score for the younger (p = .4) and older (p = .8) age groups. Between 2007 to 2016, a 1-year increase in age was associated with a .01 (95% confidence interval .005, .02) decrease in the treatment intensity score (p = .003) for patients aged 52 or older. When controlling for sex and race, a 1-year increase in age was associated with a decrease of .01 (.02, .005) in the treatment intensity score (p = .005). There was no association with those who were younger than 52 (p = .5).Discussion:Physicians provide less intense treatments for elderly patients with psoriasis. This effect has appeared in the last decade. It remains unknown if physicians are being cautious with more intense treatments in elderly patients or if they are unintentionally undertreating this population.

Journal

Journal of Psoriasis and Psoriatic Arthritis – SAGE

Published: Apr 1, 2021

Keywords: skin; dermatology; quality of life; treatment; biologic; systemic

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